Larynx and airway: radionecrosis of the larynx: practice question

A ENT question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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ENT · Larynx and airway: radionecrosis of the larynx

Sample item

A man treated by radiotherapy for glottic cancer a year ago now has pain, a new hoarse voice and airway distress. CT shows gas bubbles in the thyroid cartilage, and repeated biopsies show no tumour. What is the most likely diagnosis?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. Chondroradionecrosis of the larynx

Radionecrosis of laryngeal cartilage causes pain, oedema and airway compromise, with cartilage gas and necrosis on CT and negative biopsies. Total laryngectomy may be needed if it progresses. Recurrence must be excluded but biopsy of necrotic tissue can worsen it.

Option by option

  • A. Vocal cord granuloma

    A granuloma does not cause cartilage necrosis.

  • B. Chondroradionecrosis of the larynx (correct)

    Correct. Painful oedema with cartilage gas and negative biopsies indicates radionecrosis.

  • C. Laryngeal tuberculosis

    Tuberculosis is not suggested by cartilage gas after radiation.

  • D. Recurrent glottic cancer

    Recurrence would show positive biopsy or a soft tissue mass.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this ENT question

What is the answer to this ENT question?

The best answer is B, Chondroradionecrosis of the larynx. Radionecrosis of laryngeal cartilage causes pain, oedema and airway compromise, with cartilage gas and necrosis on CT and negative biopsies.

Why is "Vocal cord granuloma" not the answer?

A granuloma does not cause cartilage necrosis.

Why is "Laryngeal tuberculosis" not the answer?

Tuberculosis is not suggested by cartilage gas after radiation.

Why is "Recurrent glottic cancer" not the answer?

Recurrence would show positive biopsy or a soft tissue mass.

What concept does this question test?

It tests Larynx and airway: radionecrosis of the larynx in ENT. Total laryngectomy may be needed if it progresses. Recurrence must be excluded but biopsy of necrotic tissue can worsen it.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Larynx and airway: radionecrosis of the larynx?

Learn tuning fork results and audiogram patterns by sketching them. Then use the flashcards and the other ENT questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.